# INTERVENTIONAL AND VASCULAR CARE INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1275003311
- **Authorized official:** LAWRENCE RANDALL MARTIN CPA (CFO)
- **Authorized official phone:** (817) 988-0986

## Contact information

- **Practice address:** 12840 HILLCREST RD STE E104, DALLAS, TX 75230-1528
- **Practice address phone:** (214) 341-8770
- **Mailing address:** PO BOX 92670, SOUTHLAKE, TX 76092-0670

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2085R0204X | Vascular & Interventional Radiology Physician | — | NULL | Yes |
| 2085R0204X | Vascular & Interventional Radiology Physician | — | — | Yes |
| 2085R0205X | Radiological Physics Physician | — | NULL | — |
| 2085R0205X | Radiological Physics Physician | — | — | — |

## Other

- **Enumeration date:** 12/02/2018
- **Last updated:** 12/02/2018